Massachusetts regulates senior care through the Executive Office of Elder Affairs (EOEA) and the Department of Public Health (DPH), and knowing the rules helps Boston families ask better questions and spot red flags. This hub summarizes how assisted living, memory care, nursing homes, and MassHealth long-term care work in Massachusetts, and where to verify any facility's certification or license.
Every fact below applies statewide — the same regulators, MassHealth programs, and public certification/license databases cover Suffolk, Middlesex, Norfolk, and Essex counties.
Who certifies assisted living in Massachusetts
Massachusetts has no traditional "license" for assisted living. Communities that provide assisted-living-style care are certified by the Executive Office of Elder Affairs (EOEA) as Assisted Living Residences (ALRs) under M.G.L. Chapter 19D and 651 CMR 12.00. ALRs may offer Level I care (standard assisted living) or Level II care (enhanced care, typically a Special Care Unit for residents with dementia). You can look up any facility's certification status, inspection history, and deficiency findings through the Mass.gov DPH Health Care Facility search and the EOEA certified Assisted Living Residence list. We only refer families to communities with an active certification and no open disciplinary action.
Memory care: Level II / SCU, not a separate license
Massachusetts has no standalone memory-care license. A community offering dementia care most often holds an EOEA ALR certification with a Level II designation — commonly called a Special Care Unit (SCU) — and must meet the Alzheimer's Special Care Disclosure requirements under 651 CMR 12.00, with dementia-trained staff and structured routines for residents who wander or need more supervision. Always confirm the specific secured unit is covered by the facility's Level II designation and its dementia disclosure statement.
Nursing homes
Skilled nursing facilities are licensed by the Department of Public Health, Division of Health Care Facility Licensure and Certification, under M.G.L. Chapter 111, Section 71 and CMS certification, and provide 24/7 licensed medical care and post-hospital rehabilitation. You can check ratings and inspection records on Medicare Care Compare in addition to the DPH Health Care Facility search.
MassHealth long-term care: Frail Elder Waiver and Senior Care Options
Massachusetts's long-term care Medicaid runs primarily through the MassHealth Frail Elder Waiver (a 1915(c) HCBS Medicaid waiver for seniors 60 and older, administered through regional Aging Services Access Points, or ASAPs), and Senior Care Options (SCO), MassHealth's integrated Medicare-Medicaid managed care program for members 65 and older. Massachusetts is also a PACE pioneer state — for example, the Elder Service Plan through East Boston Neighborhood Health Center. These programs can cover personal care and supportive services — including in some community-based settings — for seniors who meet a nursing-facility level of care and Massachusetts's income and asset limits, but MassHealth generally does not pay ALR room and board. Verify the current SCO plan roster before relying on any specific plan name. You apply and verify eligibility through Mass.gov/MassHealth and the DPH/EOEA facility search.
Free help: the Aging Services Access Points (ASAPs)
Ethos is the Aging Services Access Point serving Boston. Nearby ASAPs include Springwell (Newton, Brookline, Watertown, Waltham area), Mystic Valley Elder Services (Malden, Everett, Medford area), Somerville-Cambridge Elder Services, North Shore Elder Services (Lynn, Revere area), and Old Colony Elder Services (Quincy, Braintree area). Each offers free options counseling, benefits screening, and caregiver support. Statewide, MassOptions (1-800-243-4636) connects families to local aging services and long-term-care options with a single free call.
Veterans
Greater Boston veterans are served by the VA Boston Healthcare System, with campuses in West Roxbury, Jamaica Plain, and Brockton. Wartime veterans and surviving spouses may qualify for the VA Aid & Attendance pension toward care costs; the VA Caregiver Support Line is 1-855-260-3274, and the Massachusetts Executive Office of Veterans' Services assists with benefit applications. The Massachusetts Veterans Homes at Chelsea and Holyoke serve veterans directly.
Reporting concerns
The Massachusetts Long-Term Care Ombudsman Program advocates for residents of long-term care facilities. To report suspected abuse, neglect, or exploitation of an older adult, call the Massachusetts Executive Office of Elder Affairs — Elder Protective Services, statewide reporting line 1-800-922-2275 (24/7).
Related: Cost of assisted living in Boston · Assisted living FAQ · Facility directory
Not sure where to start? A free Boston Senior Advisor advisor will talk it through with you — 15 minutes, no pressure, no fee. Call (617) 555-0100 or send a message.